Comment by lelanthran | Hacker News Reader

Comment by lelanthran | Hacker News Reader

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Or maybe we are too aggressive in diagnosing some quirk, trait or characteristic as a mental illness.

My ex-wife delayed a court date for maintenance by sending a lawyer with a letter from a psychologist saying she was not fit to travel to court due to very sudden onset of depression.

How many anecdotes are like this?

Especially amongst the youth; kids are pretty impressionable. Even adults up onto around age 25. It's not too hard to convince these people to find a therapist, then self-select specific symptoms to report (all therapy diagnosis is based primarily of self-reported data, not objective data).

It's not too hard to convince even a halfway selfish or self-centered person that they have a specific diagnosis, so they can say "I'm not narcisstic, I'm neurodivergent" or "I'm not a poor learner, I have ADHD/ADD" or "I'm not a lazy worker, I'm suffering from depression".

How many times have you heard this?

No one wants to admit to a character flaw; they'd rather have a sciency-sounding disorder which means that their flaws are not their fault.

People don't want agency when it comes to their flaws; that "flaw" must instead be something outside of their control.

Diagnostic criteria are imperfect. You can put the same person in front of various doctors and get differing diagnoses. On the whole though, experts tend to agree more than they disagree. Someone has to self-report symptoms that place them a couple of standard deviations away from the mean, and for many disorders like ADHD (combined type here!), you need someone who has known you for a long time like a parent or spouse that can speak to your behavior over a long span of time.

As someone who really struggled to get a diagnosis as an adult, followed by medication, I would suggest trying to get a diagnosis from a psychiatrist. Go through the process and expense and let us know how easy it is. It was a nightmare for me despite having good insurance. A doctor's note for a mental health day is very different from getting diagnosed with a developmental or personality disorder.

Lastly, while people can and often do blame their disorders for unwanted behavior, we still have agency. Most disorders are manageable with treatment, and it's possible to "cure" in certain cases. Children medicated for ADHD will most likely not need medication for it as adults. Having a disorder isn't an excuse or shield for bad behavior. In many cases you can't address the bad behavior at the root level without knowing. For my case it helped me stop being so anxious I was giving myself ulcers because I had the words to describe what was going on, and a treatment plan that I saw was giving me results. I still struggle with certain symptoms, but it is my responsibility to work through those gaps, and medication+therapy have made it possible to put in that work.

For whatever it's worth when I went to university a decade ago for my undergrad in neuroscience the figure cited was "50% of Americans will meet clinical thresholds for something in the DSM-V at least once in their life". This isn't very surprising in that light. A lot of people exist at sub-clinical thresholds.

> As someone who really struggled to get a diagnosis as an adult, followed by medication, I would suggest trying to get a diagnosis from a psychiatrist.

Diagnosis from psychiatrists are not based completely on self-reported data.

> Go through the process and expense and let us know how easy it is.

For a psychiatric diagnosis it's a long and laborious process, because those are actual doctors. Unfortunately they take referrals from Psychologists, and those diagnoses are based on almost completely self-reported data.

TLDR: It's exceptionally easy to get a Psychologist to confirm someone's self-diagnosis as long as that person knows what "symptoms" they must self-report. It's exceptionally difficult to get a Psychiatrist to confirm someone's self-diagnosis.

I am not addressing, in any way, the diagnosis from a Psychiatrist. I am limiting my argument specifically to diagnoses from Psychologists.

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